Thrombocytopenia and human immunodeficiency virus in children

M. Ellaurie, Edward R. Burns, L. J. Bernstein, Arye Rubinstein, K. Shah

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Thrombocytopenia occurs in 13% of children with symptomatic human immunodeficiency virus (HIV) infection. The clinical and laboratory course of 19 children infected with HIV with thrombocytopenia is described. Bone marrow aspirates showed normal to increased numbers of megakaryocytes. Levels of antiplatelet antibodies were increased in 80% of the children and circulating immune complexes were found in 74%. Clinically significant hemorrhage leading to anemia occurred in five patients, and CNS bleeding led to a fatal outcome in an additional three children. Spontaneous remission of thrombocytopenia occurred in three of the 19 subjects. High-dose IV γ-globulin was effective in increasing the platelet counts of six of 15 patients (40%) but resulted in a sustained remission in only one subject. Oral prednisone was effective in increasing the platelet count of two thirds of those whose platelet counts could not be controlled by IV γ-globulin. Bleeding manifestations were eliminated in all patients whose platelet counts increased significantly. Of the 11 children whose counts increased either spontaneously or as a result of therapy, eight remain alive (72%). In contrast, all of the eight patients whose platelet counts did not improve have died. Thrombocytopenia in children with HIV disease is engendered by immune mechanisms and is a major cause of morbidity and mortality. High-dose IV γ-globulin and/or corticosteroids are temporarily effective in increasing the platelet count and reducing bleeding in about half of thrombocytopenia patients and are recommended for use. The ability to respond to therapy correlates with improved survival.

Original languageEnglish (US)
Pages (from-to)905-908
Number of pages4
JournalPediatrics
Volume82
Issue number6
StatePublished - 1988

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Platelet Count
Thrombocytopenia
HIV
Globulins
Hemorrhage
Virus Diseases
Spontaneous Remission
Megakaryocytes
Fatal Outcome
Prednisone
Antigen-Antibody Complex
Anemia
Adrenal Cortex Hormones
Bone Marrow
Morbidity
Survival
Mortality
Antibodies
Therapeutics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Ellaurie, M., Burns, E. R., Bernstein, L. J., Rubinstein, A., & Shah, K. (1988). Thrombocytopenia and human immunodeficiency virus in children. Pediatrics, 82(6), 905-908.

Thrombocytopenia and human immunodeficiency virus in children. / Ellaurie, M.; Burns, Edward R.; Bernstein, L. J.; Rubinstein, Arye; Shah, K.

In: Pediatrics, Vol. 82, No. 6, 1988, p. 905-908.

Research output: Contribution to journalArticle

Ellaurie, M, Burns, ER, Bernstein, LJ, Rubinstein, A & Shah, K 1988, 'Thrombocytopenia and human immunodeficiency virus in children', Pediatrics, vol. 82, no. 6, pp. 905-908.
Ellaurie, M. ; Burns, Edward R. ; Bernstein, L. J. ; Rubinstein, Arye ; Shah, K. / Thrombocytopenia and human immunodeficiency virus in children. In: Pediatrics. 1988 ; Vol. 82, No. 6. pp. 905-908.
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